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Cardiac Surgery Can Impact Long-term Cognitive Functioning, Suggesting Need for Monitoring and Rehab

Post-Op Delirium’s Toll on Mental Function May Linger: Study (US News):

“Delirium after cardiac surgery has been thought of as a brief, reversible condition, but new research is suggesting that [mental] recovery for some people may take much longer than thought, and that there are long-term cognitive consequences,” said study co-lead author Jane Saczynski, assistant professor of medicine at the University of Massachusetts Medical School in Worcester…Patients should also have their mental functioning tested before they leave the hospital, Grote added…”You can’t rely on casual conversation to know patients are having problems,” he said. “Some are able to put up a social facade. They are chatty, witty and fun to be with, but when you start pushing you find out there’s a problem”…Saczynski said the findings also suggest that rehabilitation programs may need to continue for longer than the typical three months.”

Study: Cognitive Trajectories after Postoperative Delirium (NEJM). Abstract:

  • METHODS: “We enrolled 225 patients 60 years of age or older who were planning to undergo coronary-artery bypass grafting or valve replacement. Patients were assessed preoperatively, daily during hospitalization beginning on postoperative day 2, and at 1, 6, and 12 months after surgery. Cognitive function was assessed with the use of the Mini–Mental State Examination (MMSE; score range, 0 to 30, with lower scores indicating poorer performance). Delirium was diagnosed with the use of the Confusion Assessment Method. We examined performance on the MMSE in the first year after surgery, controlling for demographic characteristics, coexisting conditions, hospital, and surgery type.”
  • CONCLUSIONS: “Delirium is associated with a significant decline in cognitive ability during the first year after cardiac surgery, with a trajectory characterized by an initial decline and prolonged impairment.”

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